Transplant Financial Coordinator AHWFB

37811 Wake Forest Baptist Medical Center - Pre Transplant: Kidney

Full time

Yes

40

Monday through Friday. Remote role . Hours 8-5

Pay Range

$22.90 - $36.15

Major Responsibilities

• Obtain and verify detailed patient insurance benefits for all transplant-related services, including outpatient drugs, specialty pharmacy, follow-up visits, travel, and housing.
• Review, monitor, and research insurance benefits and financial needs, discussing findings with patients and families, and reporting to the transplant selection committee.
• Advise patients on insurance and billing issues, serving as a resource for financial matters throughout the transplant process.
• Develop and implement resolutions for potential out-of-pocket expenses, assisting patients in financial planning.
• Obtain necessary payor authorizations, verify transplant coverage, and acquire referrals.
• Consult with clinical staff to facilitate submission of medical documentation to insurance carriers and monitor the financial clearance process.
• Communicate with transplant coordinators and social workers regarding patient approvals.
• Assist with inpatient and outpatient admissions and financial clearances to ensure smooth facility admissions.
• Create and update patient accounts in the transplantation database, entering demographics and financial information.
• Monitor and update insurance data, physician authorizations, and preferred providers, documenting and providing updates.
• Work with reimbursement and patient billing departments to flag transplant patient accounts for cost reporting.
• Collaborate with the contracting department to establish single case agreements and assist in contracting with payors.
• Attend multidisciplinary conferences to provide updates on financial clearance for patients awaiting transplantation.
• Interface with admissions, business office, medical records, pharmacy, financial services, social services, and risk management for transplant intake and financial clearances.
• Liaise with managed care organizations, ensuring the appropriate release of medical records to insurance carriers, referring providers, and dialysis units in compliance with regulations and institutional policies.
• Partner with Finance and Managed Health Resources teams to ensure accurate billing and reimbursement under global contracts and COE agreements. Proactively resolve authorization and reimbursement challenges.
• Independently manage key administrative functions, supporting daily operations and special projects as needed.
• Enhance financial and accountability processes, implementing best practices to improve efficiency and transparency. Participates in complex initiatives by identifying opportunities for optimization within EMR workflows and processes, identifying streamlined solutions to enhance team efficiency, and engage in process improvement efforts to improve overall effectiveness.
• Participation in a muti-disciplinary council within the Transplant Center to increase cross-functional collaboration.
• Participate in on-call coverage for insurance verification for incoming transplant patients as required.
• Serve as a mentor and resource to Transplant Financial Coordinator I staff, providing guidance, training, and support.

MINIMUM JOB REQUIREMENTS

Education

High School Diploma/GED

Certification / Registration / License

CTFC certification or 5 years of Transplant experience required

Work Experience

CTFC certification or 5 years of Transplant experience required

Knowledge / Skills / Abilities

This position demands strong financial acumen, proactive problem-solving, and a commitment to process optimization.

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS

Work is primarily sedentary in nature; no special demands are required.The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

PREFERRED JOB REQUIREMENTS

Education

Bachelor's Degree

Certification / Registration / License

CFTC Certification

DISCLAIMER

All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program